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"ABSTRACTThe purpose of this study was to clarify differences in skeletal morphologies between male and female orthodontic patients with and without agenesis of all four third molars. A total of 64 patients (32 males and 32 females) with agenesis of all four third molars without agenesis of other teeth were selected as the third molars agenesis group (group 1). In addition, 64 patients (32 males and 32 females) with all these teeth were selected as controls (group 2). Lateral cephalograms taken between the ages of 14 and 30 years were used to compare skeletal morphology between groups 1 and 2 and between sexes. Maxillary length (P < 0.001), lower facial height (P < 0.05), gonial angle (P < 0.001) and mandibular plane angle (P < 0.001) were significantly smaller in group 1 than in group 2. Irrespective of the presence or absence of all four third molars, males had significantly smaller lower facial height (P < 0.01) and mandibular plane angle (P < 0.001) and significantly greater total mandibular length (P < 0.001), mandibular body length (P < 0.001) and mandibular ramus height (P < 0.001) than females. Japanese orthodontic patients with agenesis of all four third molars had significantly small maxillary length, lower facial height, gonial angle and mandibular plane angle."

"The purpose of this study was to investigate the patterns of third molar agenesis and incidence of agenesis of other permanent teeth in a Japanese orthodontic patient group. A total of 417 Japanese subjects (134 males and 283 females) with agenesis of one or more third molars were divided into four groups according to the agenesis pattern, and 874 other Japanese subjects (302 males and 572 females) without third molar agenesis were assigned to a control group. Panoramic radiographs and medical and dental records were used to examine for tooth agenesis. The Chi-square test and odds ratio were used to make statistical comparisons. The prevalence of third molar agenesis worked out at 32.3 % with no statistically significant gender difference. A high prevalence rate of agenesis of third molars, unilateral or bilateral, could be considered characteristic of the Japanese orthodontic population. Significant increases in occurrence of oligodontia, and unilateral or bilateral agenesis of other teeth, including maxillary lateral incisors and maxillary and mandibular second premolars, were observed in all or almost all of the third molar agenesis groups, compared with the controls. A significantly increased prevalence rate of mandibular lateral incisor agenesis was observed in almost all of the third molar agenesis groups. The Japanese patients with third molar agenesis had a significantly increased occurrence of oligodontia, and unilateral or bilateral agenesis of maxillary and mandibular lateral incisors and second premolars, except for bilateral agenesis of mandibular lateral incisors."

"Polimorfisme gen Pax9 yang telah dikenal sebagai gen yang bertanggung jawab terhadap terjadinya agenesis gigi. Penelitian terdahulu memperlihatkan adanya hubungan antara agenesis gigi dengan pertumbuhan skeletal maksila dan mandibula sehingga penelitian ini bertujuan untuk mengevaluasi asosiasi polimorfisme gen Pax9 rs8004560, rs2073245 dan rs2073246 terhadap Variasi Maloklusi Skeletal, Pertumbuhan Maksila dan Mandibula serta Agenesis Gigi. Penelitian cross-sectional dilakukan pada 150 pasien ortodontik RSKGM FKG UI dan diklasifikasikan berdasarkan maloklusi skeletal. Ekstraksi DNA dilakukan dengan sampel rambut yang kemudian genotyping dilakukan dengan polymerase chain reaction (PCR) dan Sanger Sequencing. Polimorfisme gen Pax9 rs2073245 dan rs2073246 konsisten dengan Hardy Weinberg Equilibrium. Asosiasi ditemukan pada polimorfisme Pax9 rs8004560 dengan agenesis gigi (p= 0.025, OR= 2.895, CI= 1.101-7.614). Tidak ditemukan asosiasi polimorfisme gen Pax9 pada studi ini dengan maloklusi skeletal.  Jumlah sampel yang lebih tinggi dengan sistem klusterisasi latar belakang etnis disarankan pada penelitian berikutnya untuk mendeterminasi peran gen Pax9 terhadap maloklusi skeletal pada subpopulasi Indonesia.

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Polymorphism Pax9 has been widely researched and known as a gene responsible for tooth agenesis, and recently been found associated with skeletal malocclusion. This study aimed to determine the association of gene polymorphism Pax9 rs8004560, rs2073245 and rs2073246 to skeletal malocclusion in Indonesia. Cross sectional study was performed to 150 Orthodontics patients and classified according to their skeletal malocclusion by cephalometric analysis. Genomic DNA was extracted from hair samples and then genotyped by polymerase chain reaction and Sanger sequencing. Gene polymorphism Pax9 rs2073245 and 2073246 are consistent with Hardy Weinberg Equilibrium. Significant association was found in polymorphism Pax9 rs8004560 with Tooth Agenesis (p= 0.025, OR= 2.895, CI= 1.101-7.614). There were no association between PAX9 polymorphisms assessed in this study with skeletal malocclusion. Our result suggested further research using larger sample size and clustered background ethnicity is required to determine the role PAX9 gene relate to skeletal malocclusion in Indonesian subpopulation."

"Latar Belakang: Kejadian malnutrisi pada pasien pembedahan mayor dilaporkan sebanyak 40% yang berhubungan dengan penurunan asupan akibat dari gejala yang dialami dan inflamasi pascaoperasi.1,2Kehilangan massa otot pascaoperasi dapat terjadi mulai dari lima hari pascaoperasi dan hal ini dapat meningkatkan risiko terjadinya komplikasi pascaoperasi. Penelitian ini bertujuan untuk mengetahui hubungan antara asupan protein pascaoperasi dengan perubahan Appendicular Skeletal Muscle Index (ASMI) pada pasien yang menjalani pembedahan mayor.Metode: Penelitian prospektif observasional dilakukan pada pasien yang menjalani pembedahan mayor di Rumah Sakit Cipto Mangunkusumo. Analisis asupan protein dilakukan selama lima hari pascaoperasi. Perubahan ASMI didapatkan dari pemeriksaan praoperasi dan lima hari pascaoperasi. Analisis data dilakukan menggunakan uji Mann-Whitney dan uji t tidak berpasangan (p < 0,05).Hasil: Penelitian ini melibatkan 110 subjek yang didominasi subjek perempuan dengan median usia 50 tahun. Terdapat 51 subjek dengan asupan protein pascaoperasi < 0,6 g/kgBB/hari dan 59 subjek dengan asupan protein pascaoperasi ≥ 0,6 g/kgBB/hari. Hasil perubahan ASMI dalam rentang -3,9 sampai 2,5 kg/m2. Setelah dilakukan analisis statistik didapatkan perbedaan bermakna rerata perubahan ASMI antara subjek dengan asupan protein pascaoperasi < 0,6 g/kgBB/hari dengan asupan protein pascaoperasi ≥ 0,6 g/kgBB/hari.Kesimpulan: Terdapat hubungan bermakna antara asupan protein pascaoperasi dengan perubahan ASMI pada pasien pembedahan mayor. Hal ini menunjukkan pentingnya pemberian protein pascaoperasi yang optimal untuk mempertahankan massa otot.

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Background: The incidence of malnutrition in major surgical patients is reported to be as high as 40%, associated with reduced intake due to symptoms experienced and postoperative inflammation. Postoperative muscle mass loss can begin as early as five days after surgery and may increase the risk of postoperative complications. This study aims to investigate the relationship between postoperative protein intake and changes in the Appendicular Skeletal Muscle Index (ASMI) in patients undergoing major surgery.

Methods: A prospective observational study was conducted on patients undergoing major surgery at Cipto Mangunkusumo Hospital. Protein intake analysis was performed over five days postoperatively. Changes in ASMI were assessed through preoperative and five-day postoperative examinations. Data analysis was conducted using the Mann-Whitney test and independent t-test (p < 0.05).

Results: The study involved 110 subjects, predominantly female, with a median age of 50 years. There were 51 subjects with postoperative protein intake < 0.6 g/kgBW/day and 59 subjects with postoperative protein intake ≥ 0.6 g/kgBW/day. The range of ASMI changes was -3.9 to 2.5 kg/m . Statistical analysis revealed a significant difference in the mean ASMI change between subjects with postoperative protein intake < 0.6 g/kgBW/day and those with intake ≥ 0.6 g/kgBW/day.

Conclusion: There is a significant relationship between postoperative protein intake and changes in ASMI in major surgical patients. This highlights the importance of optimal postoperative protein provision to maintain muscle mass."

"ABSTRAK Sella turcica is an anatomic point in the cephalometric tracing of orthodontic treatment. The formula for body mass index (BMI) is calculated by using the height and weight of an individual. Objective: To evaluate the size and morphology of the sella turcica in healthy, overweight, and obese patients. Methods: The 66 individuals (24 males and 42 females; mean age, 15.05 until 1.61 years) selected for the study were divided into three groups: obese; overweight; and healthy, according to the BMI percentile classifcation. The length, diameter and dept measurements of the sella turcica were measured on a lateral cephalometric radiograph. Results: No statistically signifcant differences were found among the groups, although the length, diameter, and depth of the sella turcica were higher in healthy individuals (P > 0.05). Moreover, the normal sella turcica, compared with other sella turcica variations, was more common in 64.7% of the healthy patients, 61.1% of the overweight patients, and 64.3% of the obese patients. Conclusions: Normal sella turcica is more common than other types of sella turcica. In addition, no signifcant difference was found among the groups in terms of length, diameter, and depth of the sella turcica. "

"Ekstraksi premolar dalam perawatan ortodonti membantu proses uprighting gigi molar 3 impaksi sehingga dapat erupsi dengan baik. Tujuan: mengukur perubahan angulasi gigi molar 3 rahang bawah yang impaksi mesioangular sebelum dan sesudah perawatan ortodonti. Metode: penelitian ini menggunakan 25 radiograf panoramik berusia 10-21 tahun sebelum dan sesudah perawatan ortodonti. Hasil: uji Wilcoxon dan uji T berpasangan (p<0,05) menunjukkan tidak ada perubahan angulasi molar 3 yang bermakna pada kedua sisi (p>0,05) dan cenderung mengalami peningkatan angulasi dengan meskipun secara statistik perbandingan perubahan keduanya tidak berbeda bermakna (p>0,05). Peningkatan angulasi paling banyak terjadi pada kelompok usia dewasa (17-21 tahun). Kesimpulan: ekstraksi premolar dalam perawatan ortodonti tidak memengaruhi angulasi gigi molar 3 impaksi secara bermakna.

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Premolar extraction in orthodontic treatment helps uprighting process of impacted third molars so that they could erupt well.

Aim: to measure mesioangular impacted lower third molars angulation change during orthodontic treatment.

Methods: this study used 25 panoramic radiograph aged 10-21 years old before and after orthodontic treatment.

Result: Wilcoxon test and paired Ttest (p<0,05) showed there were no significant change in lower third molars angulation on both sides (p>0,05) and tended to experience the increase in angulation though statistically comparison between them were not significant (p>0,05). These increase happen the most in the adult group (17-21 years old).

Conclusion: premolars extraction in orthodontic treatment does not affect impacted third molars angulation significantly."

"Latar Belakang: Diperkirakan 20-40% pasien kanker mengalami metastasis ke sistem saraf pusat (SSP). Kondisi inflamasi sistemik pada kanker yang dimediasi sitokin berkaitan dengan penurunan massa otot. Pada kondisi inflamasi, sel hepatosit terstimulasi untuk memproduksi protein fase akut c-reative protein (CRP). Kadar CRP di sirkulasi mengalami peningkatan pada lebih dari 50% pasien keganasan. CRP diperkirakan berhubungan dengan penurunan massa otot dan menjadi prediktor dini dalam kehilangan jaringan lean. Penelitian ini dilakukan untuk mengetahui hubungan kadar CRP dengan indeks massa otot skeletal (skeletal muscle mass index, SMI) pada pasien metastasis SSP. Metode: Penelitian ini adalah studi potong lintang pada pasien kanker dengan metastasis SSP di RSCM. Karakteristik subjek berupa usia, jenis kelamin, tipe metastasis, lokasi tumor primer, defisit neurologis, status performa Karnofsky, penyakit komorbid, penyakit infeksi, terapi glukokortikoid, sedang menjalani kemoterapi, radioterapi, dan tindakan bedah, indeks massa tubuh (IMT), status gizi berdasarkan IMT dan kriteria ASPEN, asupan energi, asupan protein, kadar CRP, dan nilai SMI. Dilakukan analisis hubungan kadar CRP dengan SMI.Hasil: Terdapat 57 pasien yang mengalami metastasis SSP. Mayoritas subjek perempuan (56,1%). Median usia 47 tahun. Lokasi metastasis lebih banyak ditemukan di otak (56,1%), tipe metastasis berdasarkan lokasi susunan saraf terbanyak adalah sinkronus (86%), seluruh subjek merupakan oligometastasis, dan lokasi tumor primer mayoritas berasal dari nasofaring (17,5%), payudara (15,8%), dan paru (14%). Defisit neurologis terbanyak yaitu nyeri kanker (68,4%), nyeri kepala (56,1%), dan kelemahan anggota gerak (43,9%). Kelemahan anggota gerak mayoritas hemiparesis (22,8%). Sebagian besar status performa Karnofsky pasien terganggu sedang (45,6%), 63,2% subjek tidak memiliki penyakit komorbid, 68,4% tidak memiliki penyakit infeksi, 52,6% tidak dalam terapi glukokortikoid, 75,4% subjek tidak sedang menjalani kemoterapi, masing-masing 1,8% subjek sedang menjalani radioterapi dan tindakan bedah. Rerata IMT estimasi 21,28 kg/m2 dan mayoritas status gizi berdasarkan IMT estimasi adalah berat badan normal (43,9%). Berdasarkan kriteria ASPEN, mayoritas termasuk malnutrisi sedang (49,1%) dan berat (31,6%). Rerata asupan energi 19 kkal/kgBB dan median asupan protein 0,6 g/kgBB. Median kadar CRP 46,6 mg/L dan 96,5% subjek mengalami peningkatan kadar CRP. Rerata SMI seluruh subjek yaitu 6,17 kg/m2, rerata SMI laki-laki 7,2 kg/m2 sedangkan rerata SMI perempuan 5,4 kg/m2. Terdapat korelasi negatif lemah (r=-0,373) yang bermakna secara statistik (p=0,005) antara kadar CRP dengan SMI pasien metastasis SSP .Kesimpulan: Terdapat korelasi yang bermakna antara kadar CRP dengan SMI pada pasien metastasis SSP.

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Background: It is estimated that 20-40% of cancer patients experience metastases to the central nervous system (CNS). Systemic inflammatory conditions in cancer mediated by cytokines are associated with a decrease in muscle mass. In inflammatory conditions, hepatocyte cells are stimulated to produce the acute-phase protein called c-reactive protein (CRP). Circulating CRP levels increase in over 50% of cancer patients. CRP is believed to be related to a decrease in muscle mass and serves as an early predictor in lean tissue loss. This study was conducted to determine the relationship between CRP levels and the skeletal muscle mass index (SMI) in patients with CNS metastases. Methods: This study is a cross-sectional study on cancer patients with CNS metastases at RSCM. Subject characteristics include age, gender, metastases type, primary tumor location, neurological deficits, Karnofsky performance status, comorbidities, infectious diseases, glucocorticoid therapy, undergoing chemotherapy, radiotherapy, and surgery, body mass index (BMI), nutritional status based on BMI and ASPEN criteria, energy intake, protein intake, CRP levels, and skeletal muscle mass index (SMI). An analysis of the relationship between CRP levels and SMI was conducted.

Results: There were 57 patients with CNS metastases. Most subjects were female (56.1%). The median age was 47 years. Metastases was more commonly found in the brain (56.1%), and the most common type of metastasis based on the nervous system location was synchronous (86%). All subjects had oligometastasis, and most primary tumor locations were in the nasopharynx (17.5%), breast (15.8%), and lungs (14%). The most common neurological deficits were cancer pain (68.4%), headaches (56.1%), and limb weakness (43.9%). Most limb weakness was hemiparesis (22.8%). Most Karnofsky performance status was moderately impaired (45.6%), 63.2% had no comorbidities, 68.4% had no infectious diseases, 52.6% were not on glucocorticoid therapy, 75.4% were not undergoing chemotherapy, and 1.8% each were undergoing radiotherapy and surgery. The estimated mean BMI was 21.28 kg/m2, with the majority having a normal weight (43.9%). According to ASPEN criteria, the majority were moderately malnourished (49.1%) and severely malnourished (31.6%). The mean energy intake was 19 kcal/kgBW, and the median protein intake was 0.6 g/kgBW. The median CRP level was 46.6 mg/L, with 96.5% of subjects experiencing an increased CRP level. The mean SMI for all subjects was 6.17 kg/m2, with male subjects having a mean SMI of 7.2 kg/m2 and female subjects having a mean SMI of 5.4 kg/m2. There was a weak negative correlation (r=- 0.373) that was statistically significant (p=0.005) between CRP levels and SMI in patients with CNS metastases.

Conclusion: CRP levels are correlated with SMI in patients with CNS metastasis. Higher CRP levels are associated with lower SMI in patients with CNS metastases."

"Tujuan: Menganalisis hubungan antara ukuran saluran pernapasan faring pada maloklusi kelas I dan II dengan pola pertumbuhan skeletal vertikal. Metode : Penelitian potong lintang ini melibatkan 126 sampel dengan usia 20-40 tahun yang dipilih secara konsekutif dan dibagi menjadi 2 grup berdasarkan sudut ANB yaitu : maloklusi kelas I dan II, kemudian dikelompokkan lagi menjadi 6 kelompok uji berdasarkan pola pertumbuhan skeletal vertikal (hipo-, normo-, dan hiperdivergen). Saluran pernapasan faring atas dan bawah diukur menggunakan analisis McNamara, sementara panjang saluran pernapasan faring diukur dari titik PNS-Eb. Uji hubungan ukuran saluran pernapasan faring dengan pola pertumbuhan skeletal vertikal dilakukan menggunakan uji Pearson’s Chi-Square dan dilanjutkan dengan uji korelasi Gamma untuk melihat arah hubungannya. Hasil: Analisa statistik menunjukkan tidak ada hubungan antara lebar saluran pernapasan faring atas dan bawah pada maloklusi kelas I dan II dengan pola pertumbuhan skeletal vertikal. Panjang saluran pernapasan faring pada maloklusi kelas II juga menunjukkan tidak ada hubungan dengan pola pertumbuhan skeletal vertikal, berbeda dengan maloklusi kelas I yang menunjukkan adanya hubungan antara panjang saluran pernapasan faring dengan pola pertumbuhan skeletal vertikal. Kesimpulan: Meskipun hasil analisa statistik menunjukkan tidak ada hubungan, akan tetapi lebar saluran pernapasan faring atas pada maloklusi kelas II menunjukkan pola yang unik yaitu saluran pernapasan faring atas menyempit pada pola pertumbuhan skeletal vertikal yang semakin divergen. Temuan unik lainnya dari penelitian ini adalah panjang saluran pernapasan faring berkorelasi positif dengan pola pertumbuhan skeletal vertikal pada maloklusi kelas I, yaitu semakin panjang saluran pernapasan faring dengan meningkatnya pola pertumbuhan skeletal vertikal.

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Objective: To analyse the correlation between the pharyngeal airway morphology in class I and II malocclusions with vertical skeletal growth patterns. Methods: This cross-sectional study was involved 126 samples aged 20-40 years who were selected by consecutive sampling and divided into 2 groups; class I and class II malocclusions according to ANB angle. This group will be further be divided into 6 test groups based on the vertical skeletal growth patterns (hypodivergent, norm divergent, and hyperdivergent). Upper and lower pharyngeal airway width were measured using McNamara analysis, while pharyngeal airway length was measured from the PNS-Eb point. Pearson's Chi-Square test was used to test the correlation between pharyngeal airway morphology and vertical skeletal growth patterns and proceed with the Gamma correlation test to see the direction of the correlation. Results: Statistical analysis showed that there was no correlation between the upper and lower pharyngeal airway width in Class I and II malocclusions with vertical skeletal growth pattern. The length of the pharyngeal airway in class II malocclusion also showed no correlation with the vertical skeletal growth pattern, in contrast to the class I malocclusion which showed a statistical correlation between the pharyngeal airway length and the vertical skeletal growth pattern. Conclusion: Although the results of statistical analysis showed no statistical correlation, the upper pharyngeal airway width in class II malocclusion showed a unique trend, that the upper pharyngeal airway width narrowed with an increasingly vertical skeletal growth pattern. Another trend finding from this study is that the length of the pharyngeal airway is positively correlated with the vertical skeletal growth pattern in class I malocclusion i.e., the longer the pharyngeal airway, the greater were the vertical skeletal growth pattern.

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"Gigi molar tiga merupakan gigi yang paling sering mengalami impaksi. Distribusi dan frekuensi impaksi gigi molar tiga yang mengakibatkan karies pada gigi molar dua dapat diteliti lebih lanjut. Tujuan : Melihat dan menganalisis distribusi frekuensi karies pada gigi molar dua terkait impaksi gigi molar tiga rahang bawah berdasarkan usia dan jenis kelamin. Bahan dan metode : Analisis dilakukan pada 442 kasus impaksi gigi pasien RSKGM FKG UI periode Januari 2014-Desember 2016 dengan melihat data sekunder pasien. Hasil : Jumlah kasus karies pada gigi molar dua terkait impaksi gigi molar tiga rahang bawah pada jenis kelamin perempuan lebih besar dibanding jenis kelamin laki-laki dengan perbandingan persentase 54.9 : 45.1 atau 1,2 : 1. Sedangkan untuk kelompok usia yang mengalami kasus karies terkait impaksi gigi molar tiga rahang bawah berturut-turut adalah sebagai berikut : kelompok usia 16-25 tahun 42.4, 26-35 tahun 42.4, 36-45 tahun 12.5, 46-55 tahun 2.2, 55-65 tahun 0 dan 66-75 0.5. Kesimpulan : Kelompok usia 21-25 tahun berjenis kelamin perempuan lebih rentan mengalami karies pada gigi molar dua terkait impaksi gigi molar tiga.

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Impacted third molars often occur. Frequency and distribution of impacted third molars accociated with caries on second molars needs to be investigated.

Aim: To know and analyze the frequency distribution of caries on second molars associated with impacted mandibular third molars based on age group and gender.

Method: 442 Medical records of patients with impacted teeth in RSKGM FKG UI period of Januari 2014 December 2016 were analyzed.

Results: Female were more involved than male with percentage of 54.9 45,1 or 1,2 1. Based on age group, caries on second molars associated with impacted mandibular third molars are age group 16 25 years old 42.4, 26 35 years old 42.4, 36 45 years old 12.5, 46 55 years old 2.2, 55 65 years old 0 and 66 75 0.5.

Conclusion: Female within the age group of 21 25 years old have the highest risk in caries on second molars associated with thirs molars impaction. "